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War Related Illness and Injury Study Center

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WRIISC Referral Process

WRIISC Referral Process

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Primary care providers (PCP) who see combat Veterans with chronic, medically unexplained symptoms are encouraged to refer Veterans to the WRIISC through a VA Interfacility Consult (IFC). Environmental health coordinators and clinicians can facilitate the WRIISC referral process by encouraging Veterans to schedule an appointment with their PCP who can then initiate a WRIISC consultation. WRIISC Clinical Referrals are completed using the IFC in VA’s Computerized Patient Record System (CPRS). . Detailed instructions are available here.

What information is needed to complete a WRIISC IFC?

Please provide a specific, medically unexplained clinical question that WRIISC can help address. For example:

Veteran complains of pain and fatigue since deployment. During past year, Veteran has been seen by pain, sleep, and psychiatry clinics. The Veteran has no symptom improvement despite treatment evaluations and follow-up. We request your assistance with this Veteran.

If workups are completed outside of VA, please have results in the VA medical record for review. Veterans who do not have initial workups for symptoms or had workups in the remote past will be asked to complete these evaluations first.

VA Military Environmental Exposure Assessments (MEEA) are an important step in evaluating for military exposure concerns. If a MEEA hasn't been done, this may be recommended.  Military Environmental Exposure Assessments can be scheduled through your local VA Environmental Health Coordinator or VET-HOME. If military environmental exposure concerns continue after the MEEA, please list those concerns on the WRIISC consult. If military environmental exposure concerns persist after VA Registry evaluation, please list environmental exposure concerns on the WRIISC consult.

How are referrals triaged?

Once a WRIISC Clinical IFC is submitted, referrals are assigned to the appropriate regional WRIISC based on VA Medical Center Location (see map on the Contact Us page). There are three WRIISC sites at VA Medical Centers in East Orange, New Jersey; Washington, DC; and Palo Alto, California. These three sites were set up to ensure broad geographical coverage and timely access to care.

After getting the IFC consult, WRIISC staff check the medical records for deployment status, past evaluations of symptoms, and eligibility for WRIISC services. An interdisciplinary team of WRIISC providers then creates an E-Consult report.  This report outlines recommended next steps for addressing the Veteran’s health concerns and offers resources to the Veteran and referring provider. These recommendations may include specialized WRIISC clinical services such as:

If you have any questions about WRIISC services, please contact the WRIISC located closest to your VA Medical Center.

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